A Family Cluster of Coronavirus Disease (COVID-19) Infection with Different Clinical Manifestations

Soedarsono Soedarsono


Coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) had been declared as a global pandemic by WHO. During the pandemic, a suspicion of COVID-19 infection could be found on patients presented with clinical symptoms of COVID-19. However, several new clinical symptoms of COVID-19 had also been reported recently. This caused difficulties to identify COVID-19 based on the clinical symptoms only. Real-Time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) was absolutely needed to determine the correct diagnosis. We report a family cluster of COVID-19 with different clinical manifestations to show a potential COVID-19 transmission in person who has no symptoms initially but may develop symptoms later as the incubation period varies from 5-14 days. This asymptomatic person remains potential to transmit the virus. This report describes the epidemiological, clinical, radiological, laboratory findings, and different clinical manifestation of a family cluster of COVID-19 case in Indonesia. COVID-19 was transmitted from asymptomatic person in the incubation period.


COVID-19; SARS-CoV-2; Clinical Manifestation; Asymptomatic Person


World Health Organization. Novel coronavirus – China. http://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/. 12 January 2020.

Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020. https://doi.org/10.1016/S0140-6736(20)30183-5.

World Health Organization Director-General’s opening remarks at the media briefing on COVID-19. March 2020.

World Health Organization. Naming the coronavirus disease (COVID-19) and the virus that causes it. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it (accessed Mar 24, 2020).

Russel B, Moss C, Rigg A, Hopkins C, Papa S, Van Hemelrijck. Anosmia and ageusia are emerging as symptoms in patients with COVID-19: what does the current evidence say?. Ecancer. 2020; 14: ed98. https://doi.org/10.3332/ecancer.2020.ed98.

Benezit F, Turnier P, Declerck C, et al. Utility of hyposmia and hypogeusia for the diagnosis of COVID-19. Lancet Infect Dis. 2020. https://doi.org/10.1016/S1473-3099(20)30297-8.

Yang X, Xu J, Shu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020. https://doi.org/10.1016/S2213-2600(20)30079-5.

Guan W, Ni Z, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020. https://doi.org/10.1056/NEJMoa2002032; PMID: 32109013; epub ahead of press.

Han R, Huang L, Jiang H, Dong J, Peng H, Zhang D. Early clinical and CT manifestation of coronavirus disease 2019 (COVID-19) pneumonia. Am J Roentgenol. 2020;215:1-6.

International Pulmonologits’s Consensus on COVID-19: 2nd Edition. 2020. India.

Ye F, Xu S, Rong Z, et al. Delivery of infection from asymptomatic carriers of COVID-19 in a familial cluster. Int J Infect Dis. 2020;94:133-8.

Komiyama M, Hasegawa K. Smoking cessation as a public health measure to limit the coronavirus disease 2019 pandemic. 2020;15:e16. https://doi.org/10.15420/ecr.2020.11.

Groskreutz DJ, Monick MM, Babor EC, et al. Cigarette smoke alters respiratory syncytial virus-induced apoptosis and replication. Am J Respir Cell Mol Biol 2009;41:189–98. https://doi.org/10.1165/rcmb.2008-0131OC; PMID: 19131644.

Arcavi L, Benowitz NL. Cigarette smoking and infection. Arch Intern Med. 2004;164:2206–16. https://doi.org/10.1001/archinte.164.20.2206; PMID: 15534156.

Park JE, Jung S, Kim A, Park JE. MERS transmission and risk factors: a systematic review. BMC Public Health 2018;18:574. https://doi.org/10.1186/s12889-018-5484-8; PMID: 29716568.

Full Text: PDF


  • There are currently no refbacks.